High Blood Pressure During Pregnancy: Gestational Hypertension and Preeclampsia

High blood pressure during pregnancy needs careful assessment because it can affect both maternal and fetal health. Some women enter pregnancy with chronic hypertension, while others develop high blood pressure later in pregnancy. Preeclampsia is a pregnancy-related hypertensive disorder that can affect multiple organs and can also occur after childbirth.

What is gestational hypertension?

Gestational hypertension is high blood pressure that first develops after 20 weeks of pregnancy in a woman whose blood pressure was previously normal. A single elevated reading does not by itself establish the full diagnosis; your clinician may repeat measurements and evaluate for features of preeclampsia or other causes.

What is preeclampsia?

Preeclampsia is a serious disorder usually developing after 20 weeks and characterized by high blood pressure together with evidence that pregnancy is affecting other organs. Assessment may include urine testing, blood tests, symptoms, blood-pressure trends, and fetal evaluation. Some people have few or no symptoms, which is one reason blood pressure is checked at antenatal visits.

Warning symptoms that need prompt assessment

Contact your maternity team promptly for a severe or persistent headache, visual disturbances, pain in the upper abdomen or shoulder, sudden or significant swelling of the face or hands, new breathing difficulty, or feeling acutely unwell. Severe symptoms, seizures, collapse, chest pain, or marked breathing difficulty require emergency care.

How is high blood pressure monitored?

Monitoring may include repeated blood-pressure measurements, urine and blood tests, review of symptoms, and assessment of fetal growth and wellbeing. Some women are asked to monitor blood pressure at home. Medication or timing of delivery depends on the type and severity of hypertension, gestational age, test results, symptoms, and fetal condition.

Do not self-start aspirin or blood-pressure medicines

Low-dose aspirin can reduce preeclampsia risk in selected women, but it should be recommended based on individual risk factors. Likewise, blood-pressure medication in pregnancy should be chosen and monitored by a clinician. Do not start, stop, or change these medicines without medical advice.

Sources reviewed

American College of Obstetricians and Gynecologists (ACOG): Preeclampsia and High Blood Pressure During Pregnancy, last reviewed April 2025; ACOG guidance on managing high blood pressure.

Medical review required before publication. If you are pregnant and have concerning symptoms or very high blood-pressure readings, seek clinical assessment rather than relying on online information.